Provider Demographics
NPI:1386981413
Name:BEALS, KARIN ANNETTE (APRN)
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:ANNETTE
Last Name:BEALS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:ANNETTE
Other - Last Name:BEALS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:KARIN ANNETTE BAILEY
Mailing Address - Street 1:10512 N 110TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-6636
Mailing Address - Country:US
Mailing Address - Phone:918-376-8900
Mailing Address - Fax:918-376-8990
Practice Address - Street 1:10512 N 110TH EAST AVE
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-6636
Practice Address - Country:US
Practice Address - Phone:918-376-8900
Practice Address - Fax:918-376-8990
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0070325363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200474260AMedicaid